Regarding the ACGME merger

[labtech312]

Hello Everyone,

I have a DO interview coming up soon and I am probably going to ask a question or two about the ACGME merger.

1. How do you think the merger will affect competitiveness in the match?
   
   
2. Will the merger make it more likely for students to have to take the USMLE and the COMLEX? If so will your curriculum be changing at all to reflect this?

I guess I want to ask about the merger without being to bold in my questions. What are your thoughts?

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[Magus5454]

I asked the questions in my interview and she had no issue being frank about the USMLE

 

[asnontraditionalasitgets]

Hello Everyone,

I have a DO interview coming up soon and I am probably going to ask a question or two about the ACGME merger.

1. How do you think the merger will affect competitiveness in the match?
   
   
2. Will the merger make it more likely for students to have to take the USMLE and the COMLEX? If so will your curriculum be changing at all to reflect this?

I guess I want to ask about the merger without being to bold in my questions. What are your thoughts?

I have asked very similar questions. Don’t expect revealing answers about the first question. Unless it’s one of the more established programs, in which case they will note the strength of their recent match lists.

The second question depends on the school but some schools have basically stated that they think the merger will lead to the COMLEX being more accepted. Maybe they are just thinking in terms of FM. Other schools have stated that they aren’t opposed to it, but it depends on strength of the student looking to take it. I believe @Goro says something similar about his students.

Unfortunately, there doesn’t seem to be a large change of attitude regarding the USMLE from many schools yet.

 

[Goro]

Hello Everyone,

I have a DO interview coming up soon and I am probably going to ask a question or two about the ACGME merger.

1. How do you think the merger will affect competitiveness in the match?
   
   
2. Will the merger make it more likely for students to have to take the USMLE and the COMLEX? If so will your curriculum be changing at all to reflect this?

I guess I want to ask about the merger without being to bold in my questions. What are your thoughts?

1) It will be easier to predict the outcome of the 2020 presidential election than answer this. But the indications are that it will be a good thing.
2) This is already happening. Everything I'm seeing from my own students and those on SDN are that more and more kids are taking both exams. Will curricula change? Only at the more enlightened schools. At those where the True Believers reign, no.

 

[Isoval]

1) It will be easier to predict the outcome of the 2020 presidential election than answer this. But the indications are that it will be a good thing.
2) This is already happening. Everything I'm seeing from my own students and those on SDN are that more and more kids are taking both exams. Will curricula change? Only at the more enlightened schools. At those where the True Believers reign, no.

This would be hilarious if it wasn't true.

 

[Rekt]

1) It will be easier to predict the outcome of the 2020 presidential election than answer this. But the indications are that it will be a good thing.
2) This is already happening. Everything I'm seeing from my own students and those on SDN are that more and more kids are taking both exams. Will curricula change? Only at the more enlightened schools. At those where the True Believers reign, no.

What???? This will only negatively affect DOs. It'll help the proffesion standardizing training but it's going to be harder to match. Spots for competitive specialities are already being lost to MDs and these programs are already extremely small so it's a very big hit.

As for point #2, if you're going to DO school you 100% need to go in expecting to take Step one and probably step 2 without a doubt.

 

[Shinken]

Spots for competitive specialities are already being lost to MDs and these programs are already extremely small so it's a very big hit.

Do you have data to support that assertion or is it anecdotal? It's awfully early to start making such sweeping generalizations.

So far, I've only seen positive changes as a result of the merger.

 

[CharmCity94]

Do you have data to support that assertion or is it anecdotal? It's awfully early to start making such sweeping generalizations.

So far, I've only seen positive changes as a result of the merger.

I certainly have no idea how the merger will impact DOs one way or another, but would you mind sharing the positive changes you've seen?

 

[ChiDr]

To early to call. However, I was at both DO and MD interviews and both are talking about expanding residency programs in their regions. The MD school was going to expand their OB, EM, and some fellowships by 2020. The DO was also talking about expanding IM, OB, and EM. It’s going to take time but this is at least a positive sign.

If this happens across the board, it will be positive for both sides.

 

[Jyggaswoop]

Will the merger greatly affect competitive DO students? I mean, even now many competitive students match ACGME, and the people matching AOA are the less competitive kids. I can only see the merger hurting the less competitive DO students, because they no longer have exclusive matching with AOA, and they are now competing with MD's for AOA spots. On the other hand, competitive DO students that went the ACGME route already were competing with MD students for ACGME matches.

 

[ChiDr]

Will the merger greatly affect competitive DO students? I mean, even now many competitive students match ACGME, and the people matching AOA are the less competitive kids. I can only see the merger hurting the less competitive DO students, because they no longer have exclusive matching with AOA, and they are now competing with MD's for AOA spots. On the other hand, competitive DO students that went the ACGME route already were competing with MD students for ACGME matches.

I disagree a bit. Two students, one MD and one DO both have a 250 STEP 1. Does that mean they should be considered on par? By the metric of STEP 1, yes. However, the DO doesn’t get a look because programs don’t choose DOs. That doesn’t make him/her less competitive. What is their option? Apply to AOA residency. It doesn’t mean they were less competitive.

Students who are applying to AOA competitive residencies (derm, ortho, ENT, optho, competitive surg, etc) do not have inferior scores to MD applicants by the current “gold” standard ( STEP 1). The MATCH data supports this. They have no other choice because MD programs do not look at DOs for those programs because their MD pool is large and they protect their own.

 

[Jyggaswoop]

I disagree a bit. Two students, one MD and one DO both have a 250 STEP 1. Does that mean they should be considered on par? By the metric of STEP 1, yes. However, the DO doesn’t get a look because programs don’t choose DOs. That doesn’t make him/her less competitive. What is their option? Apply to AOA residency. It doesn’t mean they were less competitive.

Students who are applying to AOA competitive residencies (derm, ortho, ENT, optho, competitive surg, etc) do not have inferior scores to MD applicants by the current “gold” standard ( STEP 1). The MATCH data supports this. They have no other choice because MD programs do not look at DOs for those programs because their MD pool is large and they protect their own.

Hmm fair point. I wasn't really focusing on the competitive specialties that you mentioned; i am really not interested in those at all. I was looking it more from the perspective of rads, anesthesia, EM, etc. I guess people gunning for the uber competitive specialties will find the merger less beneficial, but I think it will potentially make them gun even harder for high step scores, research etc, because this is what is necessary. I think that is a good thing.

 

[WorldChanger36]

It is very field/specialty dependent. I can tell you before the merger if you wanted to get into a very competitive field you had a shot in the Aoa match, now you have 1/1000 to zero chance in ACGME. Fields have become more competitive just due to volume increases. Some fields are unchanged to becoming less competitive. Primary care fields are seeing wide open doors as is pathology.
I would advise everyone to at least take step 1 regardless of what they think they want to do because stuff changes but many fields see board exams more as a checkmark so comlex or step will meet requirements.

 

[arc5005]

Hmm fair point. I wasn't really focusing on the competitive specialties that you mentioned; i am really not interested in those at all. I was looking it more from the perspective of rads, anesthesia, EM, etc. I guess people gunning for the uber competitive specialties will find the merger less beneficial, but I think it will potentially make them gun even harder for high step scores, research etc, because this is what is necessary. I think that is a good thing.

I've heard EM is getting pretty competitive now, and might be more so with the merger? Can anyone confirm this as true or pre-med neuroticism that has traveled down the grape vine? haha

 

[ChiDr]

I've heard EM is getting pretty competitive now, and might be more so with the merger?
Can anyone confirm this as true or pre-med neuroticism that has traveled down the grape vine? haha

Worry about it when the time comes. Your scores will govern what competitive means to you. Much will change in the next 2, 4, 6 years. It doesn't make sense to speculate on the unknown as physicians and PDs do not even know what will happen then. If you want to know the current state of the program, look at current data and trends over the past few years. EM scores have risen so shoot for that.

 

[Rekt]

Do you have data to support that assertion or is it anecdotal? It's awfully early to start making such sweeping generalizations.

So far, I've only seen positive changes as a result of the merger.

Where's your evidence? Please tell me how programs closing and spots being lost to MDs is a good thing. Feel free to go look at programs that have converted and see for yourself.

Tell me more about these positive changes. With how fast DO schools are expanding and building, competition will be exponentially increasing. If you're just now starting or entering this upcoming cycle you need to be on your absolute game if you want to match anything remotely competitive.

 

[AnatomyGrey12]

With how fast DO schools are expanding and building, competition will be exponentially increasing.

Eh, the people going to these schools are not generally the type that become super competitive residency applicants. That's the simple truth whether or not people want to admit it. I agree with everything else you've said.

People need to take care of their stuff if they want competitive specialties. Honestly the outline for those fields still hasn't changed all that much, except now research is more important and will be a necessity for competitive specialties. For any student wanting a competitive specialty (ortho, ENT, derm, etc) they will need at minimum a 600 COMLEX (650+ would be better, 700 is best), a few specialty specific publications/posters/abstracts, great LORs, and to strategically do auditions at places that want your application profile and kill it. Oh and I'm talking about at former AOA programs. If you want to try and break into a former ACGME program in these fields you need to be an academic superstar and get lucky.

 

[AlbinoHawk DO]

It will definitely become harder to match into any field. You no longer have the safety of the AOA. If you're at the bottom third of the class, those days where some great audition could land you something competitive are over.

Forget preferential treatment at former DO programs. Many of those programs are being ran by MDs; they simply took DOs because they couldn't get ACGME

There are more US MD schools and bigger class sizes, so more displacement. More DO schools and grads means more competition at the same level.

The IMG will continue to pay off hospitals, and although they will be slowly displayed, don't expect it to be drastic.

FMG will continue to get preferential treatment at some programs because there are FMG PDs out there helping their own.

 

[AnatomyGrey12]

If you're at the bottom third of the class, those days where some great audition could land you something competitive are over.

This is true

Forget preferential treatment at former DO programs. Many of those programs are being ran by MDs; they simply took DOs because they couldn't get ACGME

This isn't necessarily true. The majority of former AOA programs are run by DOs, and all the ones I am familiar with will continue to focus on mainly taking DOs. Yes things will get more competitive, but to say that most of these programs are run by MDs and will jump at the opportunity to take MDs is simply false.

 

[Goro]

This is true



This isn't necessarily true. The majority of former AOA programs are run by DOs, and all the ones I am familiar with will continue to focus on mainly taking DOs. Yes things will get more competitive, but to say that most of these programs are run by MDs and will jump at the opportunity to take MDs is simply false.

Following this up, programs that know your school's grads will also favor them. They're a known quantity. Med schools serve as feeders to residencies in the same way that some UG schools serve as feeders to med schools.

In addition, it appears that for once, the DO schools are doing something useful for GME and are developing their own residency programs. My school in engaged int his big time, and I'm getting word that several other schools are doing this as well. That sound you hear off in the distance is Hell freezing over.

 

[ChiDr]

Following this up, programs that know your school's grads will also favor them. They're a known quantity. Med schools serve as feeders to residencies in the same way that some UG schools serve as feeders to med schools.

In addition, it appears that for once, the DO schools are doing something useful for GME and are developing their own residency programs. My school in engaged int his big time, and I'm getting word that several other schools are doing this as well. That sound you hear off in the distance is Hell freezing over.

Additionally, Loyola is starting an EM residency, headed by a DO. It will be interesting to watch what happens.

Loyola Medicine to Offer Residency Program in Emergency Medicine

 

[Ho0v-man]

The merger will only make things harder for DOs.

Furthermore, remember that every practicing DO is not qualified to comment on the competitiveness of the match. When they matched, they could literally apply AOA, fail to match, apply acgme, fail to match, and then soap into one of the many leftover AOA spots that we’re going to be otherwise unfilled. It really seems like most faculty at DO schools do not have a clue as to how different things are now.

 

[AlbinoHawk DO]

This is true



This isn't necessarily true. The majority of former AOA programs are run by DOs, and all the ones I am familiar with will continue to focus on mainly taking DOs. Yes things will get more competitive, but to say that most of these programs are run by MDs and will jump at the opportunity to take MDs is simply false.

Except I never said "most" are run by MDs. I said that many are, and I've seen enough programs now taking MD to say that, even if these programs still take DOs, they are no longer "our" spots

 

[Magus5454]

Additionally, Loyola is starting an EM residency, headed by a DO. It will be interesting to watch what happens.

Loyola Medicine to Offer Residency Program in Emergency Medicine

Little correction, their chair of emergency medicine is a DO, the PD will be a MD

 

[Shinken]

AOA programs that become ACGME will still favor DOs. We do. So do all the other programs I know that have transitioned to ACGME. I'm sure some former AOA programs will start favoring MDs, but those programs will be in the minority.

Competitive programs are competitive regardless of whether they're AOA or ACGME. This thread makes it seem like competitive specialties were easy to get into when those programs were AOA, but now that they're ACGME they're hard to get into.

So far, the ACGME merger has been positive. DO applicants to ACGME fellowships will have no barriers to apply. There are DOs in the ACGME leadership, advocating for the profession. MDs applying to our program are excited, willing, and eager to learn OMT (and they're doing quite well applying OMT to patient encounters) - I can only hope this is the case for other programs as well.

I was very skeptical of the ACGME merger at first. But so far, what I've seen is very exciting for the profession.

 

[gp2]

I've been reading through this thread. Can anyone speak to how people that are hoping to work in less competitive specialties will be affected? Would someone interested in primary care still be advised to do USMLE study/research/etc?

 

[Chibucks15]

I've been reading through this thread. Can anyone speak to how people that are hoping to work in less competitive specialties will be affected? Would someone interested in primary care still be advised to do USMLE study/research/etc?

Build the best application you can in order to give yourself the options at the most programs so you can end up where you want to be. So yes still do it, but it isn't as do or die as if you wanted ortho or something. Do as much positive CV building (not the nonsense volunteer hours unless you actually like doing it and are committed long term) as you can, because 1. you never know if you'll change your mind, and 2. no one has been turned away for having too good of a CV

 

[WorldChanger36]

Former Aoa are still favoring DOs for the most part. Some are looking for a blend of both, some still only take DOs and some are now filling up with MDs. It all depends on many factors but most program dont want to rock the boat and want things to run smoothly, many have tons of DO student rotating through so that most of what theybare going tontake and many MD students dont see these small programs as very sexy so they avoid them for the most part.
I think many of the community programs will be a solid mix of both over time making things more competitive for most specialities.

 

[AnatomyGrey12]

I've been reading through this thread. Can anyone speak to how people that are hoping to work in less competitive specialties will be affected? Would someone interested in primary care still be advised to do USMLE study/research/etc?

I would plan on taking the USMLE as doing so will open more doors than not even in PC generally, although I’m not convinced it’s the necessity that SDN makes it out to be for PC. Research is always a plus but probably not necessary unless you want to try and climb the academic ladder in PC.

For students in that boat the inflation of the applicant pool by rapid school expansion is going to be a much bigger factor than the merger.

 

[AlbinoHawk DO]

I've been reading through this thread. Can anyone speak to how people that are hoping to work in less competitive specialties will be affected? Would someone interested in primary care still be advised to do USMLE study/research/etc?

The battle is not just getting into the specialty of your choice but also getting the right location and best training you can. I wouldn't go as far as saying stuff you hate like pre med requires, but I'd say do the best you can to have the best application by the time you interview